腹腔镜结直肠癌根治术的疗效观察

Study of curative effect of laparoscopic resection of colorectal cancer to patients with colorectal cancer

目的探讨研究腹腔镜结直肠癌根治术治疗结直肠癌患者的疗效及对患者胃肠功能与免疫功能的影响。方法选择符合标准的84例老年结直肠癌患者,随机将其分成两组:观察组42例,采用腹腔镜结直肠癌根治术进行治疗;对照组42例,采用开腹根治术进行治疗;比较两组患者总体疗效情况以及治疗后对患者胃肠功能与免疫功能的影响。结果观察组患者术中出血量、离床活动时间与住院时间分别为(83.1±12.4)ml、(21.0±7.7)h、(9.9±1.5)d,均显著性小于对照组的(155.4±25.5)ml、(32.1±4.3)h、(15.4±3.8)d(P<0.05)。观察组患者肠鸣音恢复时间、排气时间以及进食时间分别为(2.8±0.2)d、(2.6±1.0)d、(52.1±20.4)h,均显著性短于对照组的(3.4±0.4)d、(3.7±1.4)d、(109.6±30.8)h(P<0.05)。在术后观察组患者IL-6、CRP与TNF-α水平分别为(8.67±1.78)ρ/(ng·L)、(1.50±0.18)ρ/(mg·d)、(61.2±27.4)ρ/(ng·L),均显著性低于对照组的(9.45±1.92)ρ/(ng·L)、(1.87±0.20)ρ/(mg·d)、(83.1±29.6)ρ/(ng·L)(P<0.05)。结论采用腹腔镜结直肠癌根治术治疗结直肠癌,不仅术中出血量少,创伤小,同时对患者胃肠道功能的影响较小,对患者免疫系统的抑制程度也小于开腹根治术,值得在临床上推广使用。

Objective To investigate the curative effect and influence to gastrointestinal and immune function of laparoscopic resection of eolorectal cancer to patients with colorectal cancer. Methods 84 patients with colorectal cancer were chosen and divided into two groups. The observed group （42 cases） was treated by laparoscopic resection of colorectal cancer, while the control group （42 cases） was treated by radical resection operation. The curative effect and the influence to gastrointestinal and immune function were compared between the two groups. Results The bleeding amount, activities from the bed time and hospital stay time of the observed group were （83.1 ± 12.4） ml, （21.0 ±7.7） h and （9.9 ± 1.5） d, which were significantly less than that of the control group which were （ 155.4 ± 25.5 ） ml, （ 32. 1± 4.3 ） h and （ 15.4 ±3.8 ） d （ P 〈 0.05 ）. The bowel sound recovery time, exhaust time and time of food intake of the observed group were （2.8 ± 0.2） d, （2.6± 1.0） d and （52.1 ± 20.4） h, which were shorter than that of the control group which were （3.4 ± 0.4） d, （3.7 ± 1.4） d and （ 109.6 ± 30.8） h （ P 〈 0.05）. The level of IL-6, CRP and TNF-α of the observed group after the treatment were （8.67 ±1.78） p/（ng · L）, （ 1.50 ± 0.18 ） p/（ mg · d） and （61.2 ±27.4） p/（ ng · L）, which were sighificantly lower than that of the control group which were （9.45 ± 1.92） p/（ng · L）, （1. 87 ±0.20） p/（mg · d） and （83. 1 ＋ 29.6） p/（ng · L） （P 〈 0. 05）. Conclusion Laparoscopic resection of colorectal cancer has less intraoperative blood loss, smaller trauma and less influence to the gastrointestinal and immune function. It is worthy of promotion in clinic.